What is the standard adult dose and route for epinephrine 1:1000 in anaphylaxis?

• A. 0.15 mg IM
• B. 1.0 mg IM
• C. 0.3 mg IV
• D. 0.3 mg IM or SQ

Answer: (D)

The main concept is that the first-line treatment dose of epinephrine 1:1000 for adult anaphylaxis is 0.3 mg given by an intramuscular injection, usually into the mid-thigh. This route provides rapid and reliable absorption to quickly reverse airway swelling and bronchospasm. If intramuscular administration isn’t possible, subcutaneous administration of the same dose is acceptable, but absorption is slower, so IM is preferred. The other options are not appropriate: the dose of 0.15 mg is too low for an adult, 1.0 mg is an excessive initial dose, and giving epinephrine IV is not the standard initial approach for most anaphylaxis cases due to higher risk of adverse effects.